Do you ever worry that the IT department will run out of things to do? Chances are the thought never crossed your mind. With the pace of change in technology, and the need to transform the way we deliver healthcare, there is often more work than we know what to do with. To add to the fun .... the moment we start to get ahead .… something comes along to put us behind again. A regulatory body may come along to introduce new requirements. Someone introduces innovative new technology with grand promises of utopia. A vendor reminds us of a required upgrade. Or, the organization will embark on a business path that requires some form of change.
For many, it seems as though things are always in a state of catch-up. Every time you turn around, there’s a new project involving IT that “came out of nowhere”. This constant feeling of surprise can quickly lead to overwhelm. As you can imagine, it’s pretty difficult to plan for things that you don’t know about.
So where do we start? How do we get a line of sight on all the information technology (IT) projects that are coming down the pipeline?
Sources for Proposed Projects and Initiatives:
First we should recognize that new IT projects/initiatives are going to come from many sources. A collaborative approach is necessary to have broad-spectrum awareness. In my experience, there are 5 main starting points for healthcare projects that impact or involve technology.
1) Regulation or policy updates.
Changes in legislation or updates to organizational policies can often drive changes to IT systems. Examples include new privacy and security requirements or adjustments to a scope of practice. New reporting requirements to oversight bodies is another.
2) Market demand.
The use of technology continues to evolve. As this occurs, the public is increasing their expectations for healthcare organizations. Initiatives focusing on patient engagement and interactive care delivery are increasing. The use of technology is also becoming a necessity to remain competitive in the market.
3) Change in business or technical strategy.
As an organization evolves, strategic goals and objectives will change. Often requiring updates to technology. Updates to service offerings, a change in business structure (e.g. merger), or a transition to a new application platform, are all examples.
4) Improvement Initiatives.
Initiatives to improve patient outcomes and/or to increase workflow efficiency often involve IT. This category also includes efforts to improve key performance indicators (KPIs). As well as general improvements to end-user satisfaction.
5) To maintain operational status quo.
Maintaining the current state for technology often requires ongoing updates. These are sometimes referred to as Keep the Lights On (KTLO) initiatives. For example, modifications or upgrades to IT infrastructure to maintain performance levels. For many, support and maintenance contract requirements will also result in a need to update applications.
Note: It is not uncommon for a single complex project to come from many sources. For example, you may try to improve workflow efficiency in conjunction with regulatory changes. A software upgrade may also be necessary to support these efforts.
Organizations should define clear intake pathways to account for each of these potential sources. This should assist the teams with insight on the required IT projects. Note that a single path may not be possible for larger organizations. This is because there may be many entry points or decision groups bringing initiatives forward.
If intake paths are not defined, projects needing input from IT can 'sneak up on you' and catch teams off guard. This may lead to situations that result in timeline delays, reductions in scope, and/or increased costs. Either for the project in question or to other projects that are waiting on the to-do list. From a cost perspective, two impact outcomes come to mind
- It may be necessary to incur cost to maintain the defined scope and timeline. This is to incorporate the unaccounted for technology resources and components.
- To maintain the go-live date, there may need to be a reduction in scope. This can result in payments to an application vendor for functionality or modules that are not yet in use. (If included in the contract requirements.)
How to Stay Ahead of the Game
I do believe that the number of times technology departments have to scramble to ‘catch up’ with a project are being reduced. Yet, the issue still happens with some frequency in many organizations. To help reduce these occurrences even further, consider the following:
A central repository for upcoming projects/initiatives.
Having a single location for upcoming and requested projects can help increase visibility. Ensure that documentation and communication are reaching key individuals or groups. If this is not in place, consider setting up a process for capturing and communicating IT related projects brought forward.
An intake process for end-user requests.
Does the organization have a process in place for end-user initiated IT requests? Or is it common practice for clinicians and administrative staff to call an IT colleague? (Or to reach out to the vendor on their own?) If an intake and assessment process is not in place, consider establishing a basic process. Be sure to include a review step for each suggestion. To ensure that it meets strategic goals, best practice guidelines, and organizational policies.
Central contact point(s) for upcoming regulatory changes.
Assign key individuals to review upcoming regulatory and policy changes that may have IT impact. Determine which individual(s) or group(s) in the organization keep track of these types of changes for non-IT departments. Then establish open lines of communication between the identified contact points.
Leadership transparency with business/technical strategy.
Does the organization have a culture of transparency with future initiatives? Especially those that relate to market demand and business/technical strategy? It may not be feasible to have all options communicated during the concept or initial planning stages. But it can be helpful to have a process in place notifying key internal staff with connections to IT. This allows for a chance to resource and sequence any IT components ahead of communicating deadlines to a large audience.
Collaboration between biomed, clinical applications, and IT infrastructure teams.
Clinical applications, IT infrastructure, and biomedical device teams will have KTLO activities. Collaboration between these groups is key to maintain line of sight on their various IT projects. It is rare to have a project initiated by one of these three groups that does not have some impact on the others. (Even if it is only to perform testing confirming everything still works status quo.)